Clinical analysis of 14 cases with nasal respiratory epithelial adenomatoid hamartom
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摘要: 目的:探讨鼻腔呼吸道上皮腺瘤样错构瘤的临床特点和诊治方法。方法:对14例鼻腔呼吸道上皮腺瘤样错构瘤患者临床资料进行回顾性分析和总结。所有患者均于全身麻醉下鼻内镜下行鼻腔肿物切除术、鼻窦开放术。结果:14例患者中,所有患者均为双侧病变,于嗅裂区可见广基弥漫性生长的息肉样新生物,呈粉红色或粉白色,大部分肿物质韧,触之不易出血,10例患者中鼻道及总鼻道同时可见鼻息肉;鼻窦CT检查均提示双侧鼻腔(嗅裂区)可见软组织密度影,伴不同鼻窦内黏膜增厚,密度增高,均无骨质破坏。对患者术后定期随访,均恢复良好,未见复发。结论:鼻腔呼吸道上皮腺瘤样错构瘤虽罕见,但其症状、体征及影像学检查无诊断性的特异表现,容易误诊和漏诊,只有增加对该病的认识和了解,才能提高诊断率。Abstract: Objective:To describe and analyze the clinical features of nasal respiratory epithelial adenomatoid hamartom and improve the levels of diagnosis and treatment. Method:Fourteen cases of nasal respiratory epithelial adenomatoid hamartom confirmed by pathology were collected and analyzed. Result:In 14 cases,primary complaint of Hyposmia(or Anosmia)and nasal obstruction were occured in 13 and 11 cases respectively. Four cases had past history of endoscopic sinus surgery because of the diagnosis of nasal polyps. Polypoid neoplasms could be seen in the bilateral olfactory clefts.Sinus CT showed soft tissue shadows in bilateral nasal cavity and mucous membrane thickening in different sinus. Endoscopic sinus surgery were utilized to eliminate focus in all cases.All cases weren't recurred after 2-20 months' following-up visitings. Conclusion:Nasal respiratory epithelial adenomatoid hamartom is so rare that clinical and pathological doctors have limited knowledge of it. It has its own characteristics from the clinical symptoms, signs to sinus CT although they are nonspecific. So we should improve the understanding about it to avoid misdiagnosis or missed diagnosis.
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Key words:
- nasal neoplasms /
- olfactory clefts /
- hamartoma /
- surgical procedures
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[1] OWENS D, ALDERSON D, GARRIDO C.Nasopharyngeal hamartoma:importance of routine complete nasal examination[J].J Laryngol Otol, 2004, 118:558-560.
[2] METSELAAR R M, STEL H V, VAN DER BAAN S.Respiratory epithelial adenomatoid hamartoma in the nasopharynx[J].J Laryngol Otol, 2005, 119:476-478.
[3] WENIG B M, HEFFNER D K.Respiratory epithelial adenomatoid hamartom as of the sinonasal tract and nasopharynx:a clinicopathologic study of 31cases[J].Ann Otol Rhinol Laryngol, 1995, 104:639-645.
[4] LIANG J, O'MALLEY B W Jr., FELDMAN M, et al.A case of respiratory epithelial adenomatoid hamartoma[J].Am J Otolaryngol, 2007, 28:277-279.
[5] PICCIOTTI P M, CALÒ L, MULÈA, et al.Rhinosinusal bilateral hamartoma:A case report[J].Auris Nasus Larynx, 2008, 35:569-571.
[6] 郝文玮, 周慧芳, 许庆庆.鼻腔错构瘤1例报告[J].天津医药, 2014, 39 (3):246-246.
[7] 曹现宝, 马涛, 薛希均, 等.鼻腔错构瘤诊治体会 (附5例报告)[J].临床耳鼻咽喉头颈外科杂志, 2010, 24 (2):83-84.
[8] 刘庆娜, 徐卫波, 刘莹, 等.鼻部错构瘤 (附3例报告)[J].山东医大基础医学院学报, 2000, 14 (6):367-368.
[9] 曹志伟, 顾兆伟, 边志刚, 等.双侧嗅裂区呼吸道上皮腺瘤样错构瘤临床病理特点[J].临床耳鼻咽喉头颈外科杂志, 2010, 24 (11):507-510.
[10] 杨静, 曹志伟, 舒红, 等.鼻腔呼吸道上皮腺瘤样错构瘤1例[J].中华耳鼻咽喉头颈外科杂志, 2009, 44 (11):944-945.
[11] MORTUAIRE G, PASQUESOONE X, LEROY X, et al.Respiratory epithelial adenomatoid ham artomas of the sinonasal tract.Eur Arch Otorhino laryngol, 2007, 264:451-453.
[12] KESSLER H P, UNTERMAN B.Respiratory epithelial adenomatoid hamartoma of the maxillary sinus presenting as a periapical radiolucency:a case report and review of the literature[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2004, 97:607-612.
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